Provider Demographics
NPI:1104167337
Name:WU, STEPHANIE (MSW, ASW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 POWER INN RD STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6749
Mailing Address - Country:US
Mailing Address - Phone:916-388-9418
Mailing Address - Fax:916-388-9273
Practice Address - Street 1:5450 POWER INN RD STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6749
Practice Address - Country:US
Practice Address - Phone:916-388-9418
Practice Address - Fax:916-388-9273
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker